Multicenter study of principles-based waveforms for external defibrillation

Allison C. Bain, Charles D. Swerdlow, Charles Love, Kenneth A. Ellenbogen, Thomas F. Deering, James E. Brewer, Ralph S. Augostini, Patrick J. Tchou

Research output: Contribution to journalArticle

Abstract

Study objective: The efficacy of a shock waveform for external defibrillation depends on the waveform characteristics. Recently, design principles based on cardiac electrophysiology have been developed to determine optimal waveform characteristics. The objective of this clinical trial was to evaluate the efficacy of principles-based monophasic and biphasic waveforms for external defibrillation. Methods: A prospective, randomized, blinded, multicenter study of 118 patients undergoing electrophysiologic testing or receiving an implantable defibrillator was conducted. Ventricular fibrillation was induced, and defibrillation was attempted in each patient with a biphasic and a monophasic waveform. Patients were randomly placed into 2 groups: group 1 received shocks of escalating energy, and group 2 received only high energy shocks. Results: The biphasic waveform achieved a first-shock success rate of 100% in group 1 (95% confidence interval [Cl] 95.1% to 100%) and group 2 (95% CI 94.6% to 100%), with average delivered energies of 201±17 J and 295±28 J, respectively. The monophasic waveform demonstrated a 96.7% (95% CI 89.1% to 100%)first-shock success rate and average delivered energy of 215±12 J for group 1 and a 98.2% (95% CI 91.7% to 100%) first-shock success rate and average delivered energy of 352±13 J for group 2. Conclusion: Using principles of electrophysiology, it is possible to design both biphasic and monophasic waveforms for external defibrillation that achieve a high first-shock efficacy.

Original languageEnglish (US)
Pages (from-to)5-12
Number of pages8
JournalAnnals of Emergency Medicine
Volume37
Issue number1
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Fingerprint

Multicenter Studies
Shock
Cardiac Electrophysiology
Implantable Defibrillators
Electrophysiology
Ventricular Fibrillation
Clinical Trials
Confidence Intervals

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Bain, A. C., Swerdlow, C. D., Love, C., Ellenbogen, K. A., Deering, T. F., Brewer, J. E., ... Tchou, P. J. (2001). Multicenter study of principles-based waveforms for external defibrillation. Annals of Emergency Medicine, 37(1), 5-12. https://doi.org/10.1067/mem.2001.111690

Multicenter study of principles-based waveforms for external defibrillation. / Bain, Allison C.; Swerdlow, Charles D.; Love, Charles; Ellenbogen, Kenneth A.; Deering, Thomas F.; Brewer, James E.; Augostini, Ralph S.; Tchou, Patrick J.

In: Annals of Emergency Medicine, Vol. 37, No. 1, 01.01.2001, p. 5-12.

Research output: Contribution to journalArticle

Bain, AC, Swerdlow, CD, Love, C, Ellenbogen, KA, Deering, TF, Brewer, JE, Augostini, RS & Tchou, PJ 2001, 'Multicenter study of principles-based waveforms for external defibrillation', Annals of Emergency Medicine, vol. 37, no. 1, pp. 5-12. https://doi.org/10.1067/mem.2001.111690
Bain, Allison C. ; Swerdlow, Charles D. ; Love, Charles ; Ellenbogen, Kenneth A. ; Deering, Thomas F. ; Brewer, James E. ; Augostini, Ralph S. ; Tchou, Patrick J. / Multicenter study of principles-based waveforms for external defibrillation. In: Annals of Emergency Medicine. 2001 ; Vol. 37, No. 1. pp. 5-12.
@article{fee5f7f100fc4194be691d54495d84ce,
title = "Multicenter study of principles-based waveforms for external defibrillation",
abstract = "Study objective: The efficacy of a shock waveform for external defibrillation depends on the waveform characteristics. Recently, design principles based on cardiac electrophysiology have been developed to determine optimal waveform characteristics. The objective of this clinical trial was to evaluate the efficacy of principles-based monophasic and biphasic waveforms for external defibrillation. Methods: A prospective, randomized, blinded, multicenter study of 118 patients undergoing electrophysiologic testing or receiving an implantable defibrillator was conducted. Ventricular fibrillation was induced, and defibrillation was attempted in each patient with a biphasic and a monophasic waveform. Patients were randomly placed into 2 groups: group 1 received shocks of escalating energy, and group 2 received only high energy shocks. Results: The biphasic waveform achieved a first-shock success rate of 100{\%} in group 1 (95{\%} confidence interval [Cl] 95.1{\%} to 100{\%}) and group 2 (95{\%} CI 94.6{\%} to 100{\%}), with average delivered energies of 201±17 J and 295±28 J, respectively. The monophasic waveform demonstrated a 96.7{\%} (95{\%} CI 89.1{\%} to 100{\%})first-shock success rate and average delivered energy of 215±12 J for group 1 and a 98.2{\%} (95{\%} CI 91.7{\%} to 100{\%}) first-shock success rate and average delivered energy of 352±13 J for group 2. Conclusion: Using principles of electrophysiology, it is possible to design both biphasic and monophasic waveforms for external defibrillation that achieve a high first-shock efficacy.",
author = "Bain, {Allison C.} and Swerdlow, {Charles D.} and Charles Love and Ellenbogen, {Kenneth A.} and Deering, {Thomas F.} and Brewer, {James E.} and Augostini, {Ralph S.} and Tchou, {Patrick J.}",
year = "2001",
month = "1",
day = "1",
doi = "10.1067/mem.2001.111690",
language = "English (US)",
volume = "37",
pages = "5--12",
journal = "Annals of Emergency Medicine",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Multicenter study of principles-based waveforms for external defibrillation

AU - Bain, Allison C.

AU - Swerdlow, Charles D.

AU - Love, Charles

AU - Ellenbogen, Kenneth A.

AU - Deering, Thomas F.

AU - Brewer, James E.

AU - Augostini, Ralph S.

AU - Tchou, Patrick J.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Study objective: The efficacy of a shock waveform for external defibrillation depends on the waveform characteristics. Recently, design principles based on cardiac electrophysiology have been developed to determine optimal waveform characteristics. The objective of this clinical trial was to evaluate the efficacy of principles-based monophasic and biphasic waveforms for external defibrillation. Methods: A prospective, randomized, blinded, multicenter study of 118 patients undergoing electrophysiologic testing or receiving an implantable defibrillator was conducted. Ventricular fibrillation was induced, and defibrillation was attempted in each patient with a biphasic and a monophasic waveform. Patients were randomly placed into 2 groups: group 1 received shocks of escalating energy, and group 2 received only high energy shocks. Results: The biphasic waveform achieved a first-shock success rate of 100% in group 1 (95% confidence interval [Cl] 95.1% to 100%) and group 2 (95% CI 94.6% to 100%), with average delivered energies of 201±17 J and 295±28 J, respectively. The monophasic waveform demonstrated a 96.7% (95% CI 89.1% to 100%)first-shock success rate and average delivered energy of 215±12 J for group 1 and a 98.2% (95% CI 91.7% to 100%) first-shock success rate and average delivered energy of 352±13 J for group 2. Conclusion: Using principles of electrophysiology, it is possible to design both biphasic and monophasic waveforms for external defibrillation that achieve a high first-shock efficacy.

AB - Study objective: The efficacy of a shock waveform for external defibrillation depends on the waveform characteristics. Recently, design principles based on cardiac electrophysiology have been developed to determine optimal waveform characteristics. The objective of this clinical trial was to evaluate the efficacy of principles-based monophasic and biphasic waveforms for external defibrillation. Methods: A prospective, randomized, blinded, multicenter study of 118 patients undergoing electrophysiologic testing or receiving an implantable defibrillator was conducted. Ventricular fibrillation was induced, and defibrillation was attempted in each patient with a biphasic and a monophasic waveform. Patients were randomly placed into 2 groups: group 1 received shocks of escalating energy, and group 2 received only high energy shocks. Results: The biphasic waveform achieved a first-shock success rate of 100% in group 1 (95% confidence interval [Cl] 95.1% to 100%) and group 2 (95% CI 94.6% to 100%), with average delivered energies of 201±17 J and 295±28 J, respectively. The monophasic waveform demonstrated a 96.7% (95% CI 89.1% to 100%)first-shock success rate and average delivered energy of 215±12 J for group 1 and a 98.2% (95% CI 91.7% to 100%) first-shock success rate and average delivered energy of 352±13 J for group 2. Conclusion: Using principles of electrophysiology, it is possible to design both biphasic and monophasic waveforms for external defibrillation that achieve a high first-shock efficacy.

UR - http://www.scopus.com/inward/record.url?scp=0035154752&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035154752&partnerID=8YFLogxK

U2 - 10.1067/mem.2001.111690

DO - 10.1067/mem.2001.111690

M3 - Article

VL - 37

SP - 5

EP - 12

JO - Annals of Emergency Medicine

JF - Annals of Emergency Medicine

SN - 0196-0644

IS - 1

ER -